Anticipated HIV-Related Stigma and HIV Treatment Adherence: The Indirect Effect of Medication Concerns

Camacho, Gabriel; Kalichman, Seth C.; Hp, Katner

doi:10.1007/s10461-019-02644-z

Cited by 45 publications

(37 citation statements)

References 29 publications

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“…People who experienced stigma face loss of income or job, isolation from communities, and inability to participate as a productive member of society (28). Stigma is a barrier of good ART adherence which accelerates disease progression (23,(29)(30)(31)(32). It increases the risk of mental health problems (33)(34)(35).…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Predictors of Discrimination Towards People Living With HIV/ AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Arefaynie

Damtie

Kefale

et al. 2020

Preprint

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BackgroundThere is limited national representative evidence on determinants of discrimination towards people living with HIV/AIDS especially, community level factors are not investigated in Ethiopia. Thus, this study aimed to assess individual and community level factors associated with discrimination towards people living with HIV/AIDS among 15 to 49 age people in Ethiopia.MethodA secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey dataset which were collected cross-sectional. A total of 25,927 15 to 49 age people were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA version 14.0 to identify individual and community-level factors. Adjusted odds ratio with 95% confidence interval was used to show the strength and direction of association and statistical significance was declared at P value less than 0.05.Resultfrom individual variables, female [AOR=1.47, 95% CI= (1.18, 1.83)], rural dwellers [AOR=1.65, 95% CI= ( 1.23, 2.21)], not attend education[AOR=5.88,95% CI= (4.50, 7.67)], attending primary education [AOR=3.03, 95% CI= (2.40, 3.81)] and attending secondary education [AOR=1.48, 95% CI= ( 1.19, 1.82)] have discrimination attitude towards people living with HIV/AIDS. From community level factors, live in low proportion of educated communities [AOR=1.33, 95% CI= (1.01, 1.65)], live in low proportion of HIV tested communities [AOR=1.61, 95% CI= (1.33, 1.93)] were significantly associated with people living with HIV/AIDS.Conclusionsex of the respondent, religion, educational status, house hold wealth index, marital status, media exposure, internet use, HIV test status, region, residence, community level of education and community level of HIV test status have significant association with HIV related stigma in Ethiopia. Improving educational coverage, improving community level HIV/AIDS test coverage are important interventions to reduce discrimination towards people living with HIV/AIDS in the country.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Predictors of Discrimination Towards People Living With HIV/ AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Arefaynie

Damtie

Kefale

et al. 2020

Preprint

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“…28 Moreover, it is a barrier for ART adherence which accelerates disease progression. 23,[29][30][31][32] It increases the risk of mental health problems, [33][34][35] hinders the utilization of different HIV/ AIDS-related services. 31,[36][37][38] Even though, magnitude of discrimination towards PLWHA is reduced in the last decade in Africa, it is still a public health problem which affects the successes of HIV-related programs in the continent.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Discrimination Towards People Living with HIV/AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Arefaynie¹,

Damtie²,

Kefale³

et al. 2021

HIV

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Background: There is limited national representative evidence on determinants of discrimination towards people living with HIV/AIDS especially, community-level factors that are not investigated in Ethiopia. Thus, this study aimed to assess individual and community-level factors associated with discrimination towards people living with HIV/AIDS among 15-49 age people in Ethiopia. Methods: A secondary data analysis was done on the 2016 Ethiopian Demographic and Health Survey dataset which was collected cross-sectional. A total of 25,927 weighted 15-49 age people were included in the analysis. Multi-level mixed-effect logistic regression analysis was done by STATA version 14.0 to identify individual and communitylevel factors. Adjusted odds ratio with 95% confidence interval was used to show the strength and direction of the association and statistical significance was declared at P value less than 0.05. Results: From individual level factors, being female [AOR=1.47, 95% CI= (1.18, 1.83)], not attend education [AOR=5.88,95% CI= (4.50, 7.67)], attending primary education [AOR=3.03, 95% CI= (2.40, 3.81)] and attending secondary education [AOR=1.48, 95% CI= (1.19, 1.82)] have discrimination attitude towards people living with HIV/AIDS. From community level factors, live in low proportion of educated communities [AOR=1.33, 95% CI= (1.01, 1.65)], rural dweller [AOR=1.65, 95% CI= (1.23, 2.21)], live in low proportion of HIV tested communities [AOR=1.61, 95% CI= (1.33, 1.93)] were significantly associated with discrimination attitude towards people living with HIV/AIDS. Conclusion: Sex of the respondent, religion, educational status, household wealth index, marital status, media exposure, internet use, HIV test status, region, and residence, community level of education, and community level of HIV test status were predictors of discrimination attitude towards people living with HIV/AIDS in Ethiopia. Improving educational and community-level HIV/AIDS test coverage are important interventions to reduce discrimination towards people living with HIV/AIDS in the country.

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“…However, DTG-based regimens demanded a radical shift to taking ART medication in the morning. Importantly, our study suggests a link between patients deliberately taking ART medication at night contrary to clinician instruction with HIV-related stigma or the fear by patients of taking this medication in the morning at the workplace in the presence of work colleagues [47]- [49].…”

Section: Discussionmentioning

confidence: 68%

Dolutegravir-Based ART: Exploring Patient Safety and Acceptability Following National Roll-Out in Uganda

Zakumumpa¹,

Kitutu²,

Ndagije³

et al. 2021

Preprint

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BACKGROUNDThe World Health Organization recommends dolutegravir (DTG) as the backbone for first-line and second-line antiretroviral therapy (ART) worldwide. However, little is known about the acceptability and tolerability of DTG-based ART at routine points-of-care in Uganda. We set out to explore the perceptions of ART clinic managers regarding the acceptability and tolerability of DTG-based ART since national roll-out in March 2018 in Uganda.METHODSWe adopted a qualitative descriptive design involving 49 ART clinic managers and clinicians. Between September 2020 and February 2021, we conducted 22 in-depth interviews with ART clinic managers and clinicians in 12 purposively selected health facilities across Uganda. The selection of study sites ensured diversity in facility ownership-type (public/private), level of service delivery (tertiary/secondary/primary) and the four major geographic sub-regions of Uganda. We conducted three focus group discussions with 27 ART clinicians in the participating facilities. Data were analyzed by thematic approach. RESULTSThe participants acknowledged that DTG-based ART is well tolerated by the majority of their patients who appreciate the reduced pill burden, perceived less side effects and superior viral load suppression. However, they reported that a number of patients experience adverse drug reactions (ADRs) after being transitioned to DTG. Hyperglycemia is, by far, the most commonly reported suspected ADR associated with DTG-based regimens and was cited in all but two participating facilities. Insomnia, weight gain and reduced libido are among the other frequently cited suspected ADRs. In addition, ART clinic managers perceived some of the suspected ADRs as resulting from drug interactions between dolutegravir and isoniazid. Weak diagnostic capacities and shortage of associated commodities (e.g. glucometers and test kits) were reported as impediments to understanding the full extent of ADRs associated DTG-based ART. CONCLUSIONWhile DTG-based regimens were perceived to be well tolerated by the majority of patients at participating facilities, a number of patients were reported to experience suspected ADRs key among which were hyperglycemia, insomnia and reduced libido. We recommend interventions aimed at strengthening blood glucose monitoring for patients taking DTG-based regimens and precautionary assessment of all patients prior to initiating them on DTG for known risk factors for DTG related ADRs.

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Anticipated HIV-Related Stigma and HIV Treatment Adherence: The Indirect Effect of Medication Concerns

Cited by 45 publications

References 29 publications

WITHDRAWN: Predictors of Discrimination Towards People Living With HIV/ AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

WITHDRAWN: Predictors of Discrimination Towards People Living With HIV/ AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Predictors of Discrimination Towards People Living with HIV/AIDS Among People Aged 15–49 Years in Ethiopia: A Multilevel Analysis

Dolutegravir-Based ART: Exploring Patient Safety and Acceptability Following National Roll-Out in Uganda

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